Azzopardi Roberta Vella, Vermeiren Sofie, Gorus Ellen, Habbig Ann-Katrin, Petrovic Mirko, Van Den Noortgate Nele, De Vriendt Patricia, Bautmans Ivan, Beyer Ingo
Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, Brussels, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium; Frailty in Aging (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium.
J Am Med Dir Assoc. 2016 Nov 1;17(11):1066.e1-1066.e11. doi: 10.1016/j.jamda.2016.07.023. Epub 2016 Sep 7.
To date, the major dilemma concerning frailty is the lack of a standardized language regarding its operationalization. Considering the demographic challenge that the world is facing, standardization of frailty identification is indeed the first step in tackling the burdensome consequences of frailty. To demonstrate this diversity in frailty assessment, the available frailty instruments have been linked to the International Classification of Functioning, Disability, and Health (ICF): a standardized and hierarchically coded language developed by World Health Organization regarding health conditions and their positive (functioning) and negative (disability) consequences. A systematic review on frailty instruments was carried out in PubMed, Web of Knowledge, and PsycINFO. The items of the identified frailty instruments were then linked to the ICF codes. 79 original or adapted frailty instruments were identified and categorized into single (n = 25) and multidomain (n = 54) groups. Only 5 frailty instruments (indexes) were linked to all 5 ICF components. Whereas the ICF components Body Functions and Activities and Participation were frequently linked to the frailty instruments, Body Structures, Environmental and Personal factors were sparingly represented mainly in the multidomain frailty instruments. This review highlights the heterogeneity in frailty operationalization. Environmental and personal factors should be given more thought in future frailty assessments. Being unambiguous, structured, and neutral, the ICF language allows comparing observations made with different frailty instruments. In conclusion, this systematic overview and ICF translation can be a cornerstone for future standardization of frailty assessment.
迄今为止，关于衰弱的主要困境在于缺乏有关其操作化的标准化语言。考虑到世界面临的人口挑战，衰弱识别的标准化确实是应对衰弱带来的沉重后果的第一步。为了展示衰弱评估中的这种多样性，现有的衰弱评估工具已与《国际功能、残疾和健康分类》（ICF）相关联：这是世界卫生组织制定的一种关于健康状况及其积极（功能）和消极（残疾）后果的标准化且分层编码的语言。在PubMed、Web of Knowledge和PsycINFO上对衰弱评估工具进行了系统综述。然后将所识别的衰弱评估工具的条目与ICF编码相关联。共识别出79种原始或改编的衰弱评估工具，并将其分为单一领域（n = 25）和多领域（n = 54）组。只有5种衰弱评估工具（指数）与所有5个ICF组件相关联。虽然ICF组件“身体功能”以及“活动与参与”经常与衰弱评估工具相关联，但“身体结构”、“环境因素”和“个人因素”在衰弱评估工具中较少出现，主要体现在多领域衰弱评估工具中。本综述突出了衰弱操作化的异质性。在未来的衰弱评估中应更多地考虑环境和个人因素。ICF语言明确、结构化且中立，能够比较使用不同衰弱评估工具所做的观察。总之，这种系统概述和ICF翻译可为未来衰弱评估的标准化奠定基础。
